Newborn screening for congenital heart disease using echocardiography and follow-up at high altitude in China
Autor: | Hai-Ying Qi, Yuan Liu, Hong Chen, Si-Yuan Xie, Guo-Dong Zhao, Ting Dai, Jing-Jing Li, Jia Li, Lan-Fang Mu |
---|---|
Rok vydání: | 2019 |
Předmět: |
Adult
Heart Defects Congenital Male China medicine.medical_specialty Time Factors Adolescent Heart disease Septum secundum Gestational Age 030204 cardiovascular system & hematology Asymptomatic Young Adult 03 medical and health sciences Neonatal Screening 0302 clinical medicine Ductus arteriosus Internal medicine Infant Mortality medicine Humans Oximetry Prospective Studies cardiovascular diseases 030212 general & internal medicine Critical congenital heart disease Newborn screening business.industry Altitude Incidence Infant Newborn Infant Reproducibility of Results Middle Aged medicine.disease Survival Rate medicine.anatomical_structure Echocardiography Heart failure Cardiology Patent foramen ovale Female medicine.symptom Cardiology and Cardiovascular Medicine business Follow-Up Studies |
Zdroj: | International Journal of Cardiology. 274:106-112 |
ISSN: | 0167-5273 |
Popis: | Background Pulse oximetry screening for critical congenital heart disease (CHD) is inapplicable to high altitude due to the variedly decreased arterial saturations and rare complex CHD. We examined the incidence and spectrum of CHD in newborns using echocardiography at high altitude and followed up their outcomes. Methods A total of 1337 babies were studied. Echocardiography was performed in 1002 asymptomatic newborns (3–5 days). In the same period, retrospectively studied 394 newborns (≤2 days) admitted to the NICU where echocardiograph was performed in 335. In both groups, follow-up was made at 1–3, 6 and 12–18 months. Results The incidence of CHD in asymptomatic newborns was 27.8%, consisting secundum atrial septal defect (ASD) [175 (62.7%)], patent ductus arteriosus (PDA) [61 (21.9%)], ventricular septal defect (VSD) [8 (2.9%)] and multiple defects [35 (12.6%)]. And 19.4% in NICU patients with similar spectrum, except for 2 with complex CHD who died before discharge. By 12–18 months of follow-up, 30% of CHD remained open. Thirteen patients developed mild to severe pulmonary arterial hypertension (PAH), and 2 of them died of heart failure. Conclusions The incidence of CHD in newborns at high altitude is about 20 times higher than that at low altitude, consisting mostly of simple forms with left to right shunt, with rare complex CHD. By 12–18 months, the incidence of CHD is still about 10 times higher than that at low altitude. About 8% patients developed PAH or death. Follow-up must be reinforced in order to provide early intervention and prevent from PAH or death. |
Databáze: | OpenAIRE |
Externí odkaz: |